Civility is important; it is not a substitute for substance
Recently, my column making the case that schools are wrong to exclude parents from judgements about how to best support students with gender dysphoria or atypical gender expression received a reply. I’ve copied it verbatim at the end of this piece.
It’s important to restate the central theme of this debate, which is whether or not schools should actively and deliberately hide from parents potentially life-changing or life-threatening social, emotional, physical, or mental health challenges of their minor-age children.
I believe they should not. The writer and supporters of the rebuttal to my piece believe they should. It really is that simple.
I’d first like to acknowledge the civility of the reply. As my family and I continue to sponsor and support numerous activities encouraging civil discourse and debate, it is a welcome development that such a contentious issue can be discussed in this manner. I’m also glad we share a reverence for our nation’s founding documents, even as we almost certainly disagree on some of the details. That could make for some interesting debates too — for another time.
Civility is valuable because it is a social lubricant, allowing differences of viewpoint and opinion to be openly vetted, while helping to minimize the reflexive defensiveness to opposing views. I’d also like to encourage those who wish to engage in any such discussion or debates to do so openly, with their name proudly attached, rather than anonymously, as the piece below was unsigned.
Civility is not, however, a substitute for substance.
It is often employed to mask either a writer’s or speaker’s true intentions or their narrow — often very personal — views on the topic at hand. Platitudes and straw-men often serve the same purpose. The response to my piece has all of that while avoiding explicitly stating the writer’s view that schoolteachers, counselors, and administrators should not only actively hide from parents substantive challenges of their children but substitute their values and judgements over those of parents too.
Instead, the writer posits that: “…unfortunately, not all parents are supportive or understanding, and this is where schools have a vital role in ensuring that these children are affirmed, accepted, and given appropriate resources.”
Who’s going to oppose their child being “affirmed, accepted, and given appropriate resources” at school? The writer frames his position as not only a loving and non-threatening one — but essentially the only loving and non-threatening one.
But what the writer leaves out is that we’re not talking about affirming each child as a unique, worthy, and welcome member of the school community, regardless of any of their immutable characteristics. We also aren’t talking about affirming a child’s artistic expression and making sure they have the resources of paint, clay, or a stage to perform or greeting each child with a smile and a kind word or assuring they have a great teacher and well-supplied classroom.
Instead, we’re talking about a child’s serious mental health challenge the writer and other advocates want school personnel to keep secret from parents and for which the overwhelming majority of teachers, school counselors, and administrators are fundamentally unqualified to assess and treat.
Even for those rare few who might have the requisite training, experience, and legal protection, schoolchildren are in school for six or seven hours a day, five days a week 183 days a year. At the middle and high school level, where most of these circumstances arise, individual teachers or counselors might see a child for just a few hours a week. Parents have them for twice as many days, far more time each week, and have known them their entire lives.
The rebuttal states, “These children deserve our understanding and support rather than an assumption that their feelings are merely a passing phase.”
I agree all children deserve our understanding and support. I also assume nothing about the “feelings” of other parents’ children because I don’t know them well enough to do so. Neither do school personnel — or activists. Since the evidence shows that for 80% of children, feelings of gender incongruence are indeed a passing phase, supporters of school policies to automatically and surreptitiously affirm such feelings are making assumptions likely to be wrong in the overwhelming majority of cases. The actions taken on the basis of such assumptions are not benign as a mere nickname or different hair or clothes might be.
As a parent myself, I’m hardly naïve that my wife or I knew everything our daughter did or thought, nor would we have wanted to because we respected her individual autonomy. At the same time we retained appropriate parental authority as she matured. We knew her teachers and coaches would have insights about her that we did not. We considered them partners in her growth and development with the — previously unstated — understanding that we were the primary authority for every substantive decision or action affecting her life and health. Were she still a minor today, that understanding would be explicit, in writing, and legally binding.
Frankly, even if the hours were equal and every staff member were properly qualified, absent legally reportable evidence of abuse, school personnel simply have no right to impose their beliefs in such matters over those of parents. Period.
In my previous column, I linked to this ethics paper from the National Association for the Education of Young Children. I originally looked for it because I had spoken with a number of teachers who asserted their belief they had an ethical if not moral obligation to “affirm” a child’s atypical or cross-sex gender identity, even over the objections of parents, and in secret if necessary. These were good teachers with excellent reputations among students, parents, and administrators. They weren’t ideologues so I thought there had to be some basis for their views.
I read the paper, followed all of the references, and read those too. It is as close to a smoking gun to justify teachers usurping parental rights and responsibilities as I could find. It’s also devoid of good evidence, relying instead on hypotheses, anecdotes, biased surveys, and underpowered and/or poorly controlled studies. Then again, so is most of what passes as official policies for “gender affirming care” in the U.S.
As I wrote in my previous column, progressive countries around the world have abandoned the affirmation-only model for child and adolescent gender care in favor of a much more gradual, restrictive, highly controlled, and psychotherapy-focused approach. They did so after conducting systematic reviews of the evidence, which they found so lacking as to provide its own ethical obligation to change course. Such systematic evidence reviews are considered the gold standard for Evidence-Based Medicine (EBM).
Which brings me to the sad case of the American Association of Pediatrics (AAP). A link to AAP’s 2018 gender care guidance is the only link to be found in the rebuttal below. Contrary to the rebuttal’s assertion that “growing evidence showing that such an [affirmation] approach benefits these children’s mental health and overall well-being”, the growing evidence in the five years since AAP’s guidance in fact shows exactly the opposite, as the countries and professional organizations that have reviewed the evidence have concluded.
Similarly, the Endocrine Society in the U.S. claims to have relied on two evidence reviews, the quality of which they themselves described as “low to very low”, but drew affirmative conclusions from them anyway. In a pointed rebuke, 21 clinicians and researchers from nine countries wrote a letter refuting the claims of Dr. Stephen Hammes, President of the Endocrine Society. U.S. medical association leadership is consistently choosing to ignore the evidence in favor of The ScienceTM.
I thought AAP’s appalling abandonment of the best interests of children to be bad enough when they did an abrupt about-face (pun intended) in the summer of 2020 away from their long-standing guidance emphasizing the importance of children seeing faces and fully supporting school openings. Instead, they memory-holed all of those previous references from their website and adopted some of the most restrictive school opening recommendations, including masking of toddlers (except, of course, when they’re napping in the same room as dozens of other little ones). None of those recommendations had good evidence, and the policies harmed millions of children in the U.S. alone, some of which I addressed in The Covid Reckoning, Part 1.
But I digress. Not only has AAP failed to conduct a thorough evidence review of child and adolescent gender medicine, they have repeatedly rejected calls from their members to do so. AAP leadership is apparently so fearful of what they might find in a fulsome evidence review that last year they blocked a member-supported resolution to conduct such a review and adopted new rules designed to prevent members from even commenting on it. Fortunately, at least one of those members leaked emails documenting AAP leadership’s anti-science abuses.
I have no doubt the overwhelming majority of pediatricians care deeply about children and are committed to providing them the best possible care. I’d bet that’s even true for the docs in AAP leadership. But they’re still human, subject to the same psychological and ideological traps that can befall anyone. A mass exodus of members to form a new organization or election of new leaders and repudiation of previous guidance are probably the only solutions to restore AAP’s credibility.
If I were to recommend any of AAP’s guidance on this topic, it would be their policy on informed consent for pediatric medicine, which does a good job of recognizing both the progressive capacity of children to be part of the medical decision-making process as they mature as well as the importance of parental involvement throughout. It was written in 2016, before most of AAP’s more recent ideological capture. It is a nuanced examination of the issues involved yet still includes this statement:
“A child is not the final decision-maker, the parent or surrogate is.”
School personnel are not legal surrogates unless they have been so designated by written agreement, court order, or under law when acting in loco parentis (in place of a parent). If none of those conditions have been met, school personnel have no legal or ethical right or obligation to keep matters of such magnitude secret from parents.
Advocates for empowering schools to keep secrets from parents want to frame this not “as a debate over gender ideology, [but] …as a conversation about human rights and mental health.”
Since both gender ideology and “gender affirming care” are amorphous terms with little to no objective standards of evidence, I’d want to change the subject too. But what about human rights and mental health?
For all the reasons (and many more too) discussed in AAP’s informed consent document, nowhere, including the U.S., do children have the same legal rights as adults. They simply lack the cognitive, decision-making, and impulse control capacity of adults and are held to different standards as a result. I’m glad most places are moving away from the historical view of children as the property of their parents, with no rights at all beyond those arbitrarily granted or withdrawn. I am equally appalled by the (re)emerging view of children as the property of the state — or the school — where parents’ views and wishes are subservient to those of the state, if they’re considered at all. History should have taught us of the horrific consequences of that view.
I completely respect teachers’ commitment to their role and their care for children such that they refer to the students in their classes as “their kids”. Such relationships can be so positive that they create lifelong fond memories and even friendships as the children mature into adults. I am still in contact with my junior and high school music teachers and regularly invoke the lessons I learned from them. Regardless of the friendly or familial term of affection used, minor students aren’t the teacher’s or the state’s kids; they are their parent’s kids — not as their owners but as their legal, moral, and ethical guardians.
A village can indeed be a wonderful place to support the development and safety of the children who live there, but it is not a substitute for the nuclear family. The only exceptions are those sad cases where parents or other family are unable to care for them either because of death, abandonment, or where they have been properly adjudicated as a bonafide threat. None of those circumstances apply to children whose parents reject their — overwhelmingly temporary — gender confusion. The same is true for concerns about children’s mental health. I’ll quote from my first column on this topic 7 months ago, after the activists against our school’s parental consent requirement had spent months attacking me for championing it:
I am glad our society is becoming more accepting of the vast range of human diversity and expression as we all benefit when each of us can be comfortable in our own skin. I want every one of our students to feel safe, supported, and connected at school. But especially as it relates to minor children, caution, patience, and extensive professional assessment, rather than unquestioned affirmation by strangers are warranted.
And:
I …believe every student in our district, and indeed every child, deserves to be treated with kindness, dignity, and respect. I’m sure every parent can agree that sometimes those values require us to say no.
That is what the evidence shows is best for children’s mental health. Parents have a vital role in that process and must not be excluded from it based on mere ideology.
********************************
The following text is copied verbatim from a rebuttal to my earlier column:
“Phil, I find it ironic, even paradoxical, that as we engage in this conversation, we both draw inspiration from foundational texts like the Declaration of Independence and the U.S. Constitution. These documents underline the essential rights of individuals and the necessity for just representation and protection, irrespective of the magnitude of the group they belong to. They, to me, represent the ultimate commitment to equity, freedom, and dignity for all people – a philosophy I believe should apply to all students, including those who are transgender or gender non-conforming.
I respect your perspective, Phil, but I’d like to provide a counter-argument considering another aspect of this contentious issue. I agree with you that the primary focus of school education should be teaching foundational literacy and knowledge. However, it’s also essential for schools to ensure their students’ well-being, including the mental health of transgender and gender non-conforming youth.
You assert that most of these issues are brought up by narrow interest groups, suggesting that they don’t align with the interests of most students and families. However, in the spirit of our shared inspirational sources, it is crucial to recognize that the rights and well-being of minority groups should never be disregarded just because they represent a smaller portion of the population. Ensuring that every student feels seen, valued, and accepted for who they are should be a universal interest, not a narrow one.
The notion of “settled science” you argue against is indeed complex and continually evolving, just like any scientific field. But we should not overlook that numerous professional organizations, including the American Academy of Pediatrics, support affirming transgender and gender-diverse youth in their identities. These guidelines are not based on fleeting fads but on growing evidence showing that such an approach benefits these children’s mental health and overall well-being.
The studies you’ve referred to suggest that many children experiencing gender dysphoria may later align with their assigned sex. However, it’s also important to note that others do persist in their transgender identities into adulthood. These children deserve our understanding and support rather than an assumption that their feelings are merely a passing phase.
You express concern over the role of schools in supporting transgender youth without parental knowledge. It is indeed desirable that parents are involved in these important aspects of their children’s lives. But unfortunately, not all parents are supportive or understanding, and this is where schools have a vital role in ensuring that these children are affirmed, accepted, and given appropriate resources.
Your citation that 41% of transgender youth attempt suicide as flawed doesn’t negate the undeniable fact that transgender youth face significantly increased risks of mental health issues, including suicidal ideation, often due to social stigmatization, family rejection, and lack of support. Policies, therefore, need to prioritize their well-being and mental health.
Rather than seeing this as a debate over gender ideology, we should frame this as a conversation about human rights and mental health. School policies should, above all, ensure that every child, regardless of gender identity, feels safe, accepted, and valued. Transgender and gender non-conforming youth should have access to the same levels of support and respect available to all other students, following the promise of our foundational texts to safeguard the rights and liberties of all individuals.”